术前彩色多普勒血流成像血流参数对分化型甲状腺癌患者颈部淋巴结转移的诊断价值

Diagnostic value of preoperative color Doppler flow imaging blood flow parameters in cervical lymph node metastasis of differentiated thyroid cancer

目的探讨术前彩色多普勒血流成像(CDFI)血流参数对分化型甲状腺癌(DTC)患者颈部淋巴结转移的诊断价值。方法选取90例DTC手术患者,术前均接受CDFI检查,依据病理结果颈部淋巴结转移情况分为转移组(n=50)和未转移组(n=40),比较两组患者超声图像特征、术前CDFI血流参数[阻力指数(RI)、搏动指数(PI)、收缩期和舒张期流速比(S/D)]。相关性分析采用Spearman相关分析;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估CDFI血流参数单独及联合检测对DTC患者颈部淋巴结转移的诊断价值。结果转移组患者钙化、血流丰富、纵横比≥1的比例均高于未转移组(P﹤0.05),RI、PI、S/D均明显高于未转移组(P﹤0.01)。RI、PI、S/D与DTC颈部淋巴结转移均呈正相关(r=0.388、0.359、0.377,P﹤0.01)。RI+PI+S/D联合检测诊断DTC患者颈部淋巴结转移的AUC为0.853(95%CI:0.776~0.930),均高于各指标单独检测。结论术前CDFI血流参数与DTC颈部淋巴结转移呈正相关,RI+PI+S/D联合检测诊断DTC颈部淋巴结转移的价值较高。

Objective To investigate the diagnostic value of preoperative color Doppler flow imaging(CDFI)flow parameters for cervical lymph node metastasis in differentiated thyroid cancer(DTC).Method A total of 90 patients with DTC surgery were selected,all received CDFI examination before operation,and were divided into metastasis group(n=50)and non-metastasis group(n=40)according to the pathological results of cervical lymph node metastasis.The ultrasound image characteristics and preoperative CDFI blood flow parameters[resistance index(RI),pulsatility index(PI),systolic and diastolic velocity ratio(S/D)]were compared between the two groups.Correlation analysis was performed using Spearman correlation analysis.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the diagnostic value of CDFI blood flow parameters alone and in combination in the diagnosis of cervical lymph node metastasis in DTC patients was evaluated.Result The proportions of calcification,abundant blood flow,and aspect ratio≥1 in the metastatic group were higher than those in the non-metastatic group(P<0.05),and RI,PI,and S/D were significantly higher than those in the non-metastatic group(P<0.01).RI,PI,S/D were positively correlated with DTC cervical lymph node metastasis(r=0.388,0.359,0.377,P<0.01).The AUC of RI+PI+S/D combined detection in the diagnosis of cervical lymph node metastasis in DTC patients was 0.853(95%CI:0.776-0.930),which was higher than that of each index alone.Conclusion Preoperative CDFI blood flow parameters were positively correlated with DTC cervical lymph node metastasis,and the combined detection of RI+PI+S/D had a higher value in diagnosing DTC cervical lymph node metastasis.